But this imperative is more difficult than it might sound. The multiple misunderstandings surrounding the appropriate use of opioids—particularly their role in chronic pain management—and the historical lack of opioid-related clinical data have made it challenging for physicians, and physician leaders, to educate themselves and their teams.
Fortunately, emerging technologies and studies are beginning to clarify the most effective and safest manner in which physicians should prescribe opioids. Although research continues to expand our understanding of opioids, and pain management in general, there are two steps physician leaders can take right away to help their teams optimize opioid prescribing behaviors:
1) Dispel common myths surrounding prescription opioids
First, and most importantly, physician leaders should standardize clinician education by dispelling common misunderstandings. Chief among these are the following:
- Though opioids may be effective for short-term acute pain, no studies have confirmed opioids are the most effective option for long-term pain management—and they may even be harmful when compared with non-opioid agents. Clinicians should strongly consider whether the long-term use of opioids is the most appropriate treatment for chronic pain, especially for common orthopedic conditions such as back and extremity pain;
- Research has found no correlation between increased opioid prescriptions and increased HCAHP scores. In fact, a 2017 study found that clinicians who reduced their opioid prescriptions did not experience any decrease in HCAHP scores; and
- Clinicians cannot guarantee that the individual receiving the opioid prescription is the one who will ultimately use the opioids. Approximately 54% of surveyed individuals taking illegal opioids reported obtaining them through a relative or friend.
2) Use available safety guidelines and data to help clinicians understand areas for improvement
Ultimately, clinicians can only improve opioid prescribing behaviors if they understand what safe prescribing looks like and the clinical areas where prescribing behavior is currently falling short.
Although many organizations may want to create their own prescribing protocols to reflect the needs of their region and to ensue appropriate clinician input, CDC's Guidelines for Prescribing Opioids for Chronic Pain can serve as an important starting point. These guidelines offer federally recognized standards for granular issues such as prescription length and dosage amount.
Beyond clear protocols, clinicians also need to understand where their prescribing patterns are currently unsafe or not in compliance with standard guidelines. The Advisory Board, in collaboration with OptumLabs (a scientific research collaborative and co-innovation center supported by over 25 different partnerships with leading health care organizations), has created a new analytic tool, the Opioid Population Profiler, designed to provide this data on a county-by-county level. Physician leaders can use this tool to understand the clinical areas of greatest need within their region and to help educate their teams on how their counties compare with the national average.
Interested in learning more about how you can expand your role in combatting the opioid epidemic? Explore all the ways we can support your team on our opioid resources landing page.
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